But when Munoz collapsed and was found with no breath or pulse in November, possibly caused by a pulmonary embolism, she was 14 weeks pregnant. She had been without oxygen for too long for her brain to recover, but her heart was revived by electric shock, and doctors found a fetal heartbeat. Under the Texas Advance Directives Act, the state of Texas requires that "a person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient." The hospital interpreted this to invalidate her wishes, even though experts interviewed by the Associated Press said a brain-dead patient would not be covered by the law. A 2012 report by the Center for Women Policy Studies found that Texas is one of 12 US states that invalidate a woman's end-of-life wishes if she is pregnant.

Munoz's family also worries about the health of the fetus. "That poor fetus had the same lack of oxygen, the same electric shocks, the same chemicals that got her heart going again," said her father Ernest Machado. "For all we know, it's in the same condition that Marlise is in."